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目的 研究孔源性视网膜脱离患者黄斑表面膜 (macular pucker,MP)的超微结构 ,探讨 MP的发生机制。 方法 13例孔源性视网膜脱离患者的 2 0块 MP通过玻璃体手术获取 ,根据剥膜时所处的上下层位置分为靠近玻璃体一面膜和紧贴视网膜面膜 ,二个位置膜组织进行对比性透射电镜观察。 结果 7块近玻璃体的 MP以大量胶原纤维为主 ,分布的细胞是一些上皮样细胞 ,胞浆可含有色素颗粒 ;13块近视网膜面 MP有大量足突细胞 ,其周围胶原丰富 ,细胞数量和类型增多 ,包括典型的成纤维样细胞和神经胶质样细胞。 结论 视网膜脱离术后 MP的组织结构表现层次上差异 ;玻璃体后界膜积极参与 MP的形成 ;研究提示玻璃体后界膜在黄斑部粘连是发生继发性 MP的一个原因。临床表现 ,患者通常为不完全性玻璃体后脱离
Objective To study the ultrastructure of macular pucker (MP) in patients with rhegmatogenous retinal detachment and to explore the mechanism of MP. Methods Twenty-three MPs from 13 patients with rhegmatogenous retinal detachment were obtained by vitrectomy. According to the location of upper and lower layers, the vitreous and facial mask were placed close to the retina and the two locations were compared for transmission Electron microscopy. Results Seven vitreous MPs were predominated by a large number of collagen fibers. The distribution of cells was epithelial-like cells. Cytoplasm could contain pigment granules. Thirteen MPs had a large number of podocytes with abundant collagen around them, The type is increased, including typical fibroblast-like cells and glial-like cells. Conclusions The histopathological changes of MP after retinal detachment are different. The vitreous posterior parietal membrane is actively involved in the formation of MP. The study suggests that the posterior vitreous adhesions in the macula are one of the causes of secondary MP. Clinical manifestations, the patient is usually incomplete posterior vitreous detachment